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Serious discussion. Professional social worker actively gesticulating while speaking and looking straight into eyes

At the start of October 2022, a meeting was held to explore the potential role of social prescribing for people with lived experience of prison (PwLE). It was attended by 36 individuals from a range of backgrounds - PwLE, social prescribing link workers, staff working for the prison service and researchers. The meeting ran for two hours online. Stephanie Tierney, Health Services Researcher at the Centre for Evidence Based Medicine, presented at the event. She currently co-leads a study on the link worker role in primary care. Link workers are often employed to work in GP practices. They are key to social prescribing. They encourage patients to talk about challenging social, emotional and/or economic circumstances affecting their health and well-being. They then connect patients to groups/organisations/services in the community that are relevant to their needs and preferences.


In this blog, Stephanie reflects on some key topics that were raised and discussed at this knowledge exchange event.


Optimum time for intervention

There was discussion about when link workers might get involved in supporting PwLE. It was acknowledged that these employees have excellent local knowledge, are good at working across sectors and have time to really understand someone’s needs. Outreach to prisons was therefore proposed as an option, with link workers visiting individuals who were nearing release. It was suggested that their interaction with PwLE should not be left until the last minute because of the time it can take to set up activities or links to services in the community. Prison healthcare teams, and organisations supporting individuals leaving prison, might find it helpful to have a list of link workers in their local area. However, it was noted that PwLE often go to live some distance from a prison; hence, local link workers might not have knowledge of the area someone is moving to upon release. There was general consensus among PwLE that social prescribing should be available throughout someone’s whole journey in prison (not limited to when they are being released). Yet whether the infrastructure was available to support this was questioned. Some prisons were described as offering a range of activities and opportunities that could form part of social prescribing. However, such provision was depicted as patchy.


A need for direction upon release

It was noted that on leaving prison, PwLE can encounter a lack of purpose. The idea of ‘learned helpless’ was mentioned on several occasions, and how this could be difficult to shake off upon release. Attendees remarked that people leaving prison may need support and encouragement to become involved in community activities, which could be a daunting prospect as the familiar boundaries and processes of a prison are left behind. It was felt that link workers could assist with this given their local knowledge of available services and support. However, it was suggested that PwLE may be reticent to open up to a link worker in case what they said was reported back to their probation officer.


'Buy-in’ to the idea of social prescribing

The potential of social prescribing in prisons was highlighted during the meeting, but it was stated that this would call for sustained investment from commissioners, rather than it receiving money when an end of financial year came around and there were available resources. Buy-in to the benefits of social prescribing by prison officers was depicted as a potential challenge to effective service delivery. It was also proposed that PwLE must accept the idea of social prescribing for it to work, feeling confident in and able to trust a link worker, and willing to take up and try new things.


Following this useful meeting, it is hoped that social prescribing can be piloted and evaluated in a prison, taking into consideration the learning to come from this knowledge exchange event. It is anticipated that the service will be co-produced with PwLE.


Stephanie is co-leading, with Kamal Mahtani, a study funded by the National Institute for Health and Care Research (NIHR130247). The views expressed are those of the author and not necessarily those of the NIHR, the Department of Health and Social Care, or the author’s host institution.